Mr James Quincey Derrick, PA is a medicare enrolled "Physician Assistant" in Tierra Amarilla, New Mexico. His current practice location is
Cr 0324 Hwy 84 N #14, Tierra Amarilla, New Mexico. You can reach out to his office (for appointments etc.) via phone at
(575) 588-7252.
Mr James Quincey Derrick is licensed to practice in New Mexico (license number PA2009-0016) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1346471802.
Provider's Profile
Full Name | Mr James Quincey Derrick |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | Cr 0324 Hwy 84 N #14, Tierra Amarilla, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1346471802
- Provider Enumeration Date: 07/31/2009
- Last Update Date: 08/22/2011
Medicare PECOS Information:
- PECOS PAC ID: 5395886055
- Enrollment ID: I20100104000491
Medical Identifiers
Medical identifiers for Mr James Quincey Derrick such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1346471802 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA2009-0016 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr James Quincey Derrick is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr James Quincey Derrick, PA Po Box 250, Tierra Amarilla, NM 87575-0250 Ph: (575) 588-7252 | Mr James Quincey Derrick, PA Cr 0324 Hwy 84 N #14, Tierra Amarilla, NM 87575 Ph: (575) 588-7252 |
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